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Wednesday, October 01, 2014

are we ready for something like ebola? Of course not.

You know what I love? When officials get on TV and say things like the medical profession and hospitals have been "practicing for years how to deal with something like ebola". Really? What does that really mean? I haven't been doing any practicing and I have been working in the ER for years. I am on the front lines of medicine where those patients will show up first.

I always feel like we are not prepared for any disaster, let alone some hemmorhagic fever.

If they mean, if you came in with vomitting, fever, muscle pain, etc and said you had travelled to West Africa, would I put a mask on you? Sure. I would put you in one of the two isolation rooms we have in the ER. We would put you on contact precautions. contact precautions mean we wear gloves and a gown. Is this enough?

When you see somebody on TV in West Africa treating people for ebola they are dressed from head to toe in an outfit. They have a hood over there head. They have things over their shoes. They have people there whose only job is to dress those people to care for them. The way they are dressed reminds me how we used to dress for chemical warfare training.

Do we have access to these kind of outfits? Not that I know of.

What would we do with their family members accompanying them? There are many questions that arise. No one has said ANYTHING to us except saying we should ask people at triage whether they have travelled outside the country.

You probably think I am overreacting. Come on....its never going to happen at your local ER. You are probably right. It is scary nonetheless. It brings this fact front and center: Most ERs are not ready to deal with something like this and they should be.

In the US, we have laws (specifically: EMTALA) that require us to treat any person that presents to the emergency department, regardless of insurance or ability to pay. They would end up admitted and in isolation much like any one else. Even if said law were not in place, our public health system (and CDC) would intervene and isolate the individual in order to prevent a crisis (for example, see Typhoid Mary).